Clinical characteristics and treatment of patients(aged 14 to 44 years)with chronic subdural hematoma

ZUO Da-hui; JIANG Tai-peng; HE Jia-bin; LIN Heng-zhou; WANG Jian-zhong

doi:10.13798/j.issn.1009-153X.2023.09.004

Abstract：Objective To investigate the clinical characteristics,and treatment and its curative effectiveness of chronic subdural hematoma(CSDH)in patients aged 14 to 44 years.Methods The clinical data of 38 patients(age,14～44 years)with CSDH who were admitted to our hospital from January 2011 to December 2022 were retrospectively analyzed.Results Of these 38 patients,32 were male and 6 female.Fifteen patients had arachnoid cyst,1 had decreased activity of coagulation factor Ⅷ,and 1 had decreased activity of factor Ⅺ.Two patients underwent ventriculoperitoneal shunt due to hydrocephalus.Two patients had hypertension.Acute subdural hematoma converted to CSDH in 2 patients.Fifteen patients had no comorbidities.One patient with decreased activity of coagulation factor Ⅷ received conservetive treatment and was automaticly discharged to lost follow-up.Burr hole drainage(BHD)was performed in the other 37 patients,of whom 28 patients were cured after one operation,and 9 recurred after the first operation(4 received BHD again,5 conservative treatment).Complete brain tissue recovery was observed in 1 patient during the operation,in 4 patients within 3 days after the operation,in 17 patients within 7 d～1 month after the operation,and in 5 patients within 1 month after the operation.Postoperative follow-up(range,1～12 years)showed no recurrence in the 37 patients with normal life.Conclusions CSDH is more common in young men,and is often complicated with other diseases(arachnoid cyst,coagulation dysfunction,etc.).The first choice of treatment is the BHD,which can achieve a good prognosis,but attention should be paid to the treatment of the comorbidities.Patients with arachnoid cysts have a high rate of rebleeding after BHD.If patients have no intracranial hypertension,follow-up observation can be used.